Background:Pain after laparoscopic gastric bypass surgery (LGBP) is a major problem. Gabapentin is an anticonvulsant drug that can be effective in postoperative pain control.Objectives:This study examined the effect of preoperative administration of gabapentin on reducing pain after LGBP in patients with morbid obesity.Patients and Methods:This randomized clinical trial was performed in Hazrat Rasoul Akram Medical Center in Tehran. A total of 60 patients undergoing LGBP were randomly allocated into two groups; one group received 100 mg of oral gabapentin and the other group received placebo. Pain was evaluated at recovery time, and at the first, second, fourth and sixth hour of surgery by visual analog scale. The number and dose of opioid use after surgery and incidence of postoperative complications, such as nausea and vomiting, agitation, and headache, were also recorded.Results:The mean pain score in the group receiving gabapentin was significantly lower than the placebo group (P < 0.001). Indications and dose of opioid consumption between the two groups were not statistically significant. Incidence of nausea/vomiting (P = 0.028) as well as agitation (P = 0.037) was significantly lower in the gabapentin group.Conclusions:Administration of gabapentin before surgery can reduce pain after LGBP. Furthermore, it is not accompanied by significant short-term adverse effects.

Our study demonstrated a high frequency of vitamin D deficiency among Iranian children, particularly the obese ones. Moreover, low therapeutic response in the obese group is witnessed.

Background:Development of a manual or well-defined criterion for prioritizing the topics of clinical practice guidelines (CPGs) will help validate and organize this process evermore. This study was conducted to design an applicable manual that would prioritize the CPG topics for family physicians.Methods:This study was a multi-stage method using a qualitative approach that was conducted for the manual developing. The manual development process took place in four steps, as follows: Literature review, interviews with ten experts, preparing a list of criteria and determining its appropriateness by applying the RAND/UCLA Appropriateness method, and development of the final draft of the manual and pilot study.Results:Interview transcripts went under content analysis and were classified into eight main groups, 12 subgroups, and 85 themes. A comprehensive list consisting of fifty preliminary criteria were extracted. After summarizing and classifying the criteria, 12 appropriate criteria were evaluated using the RAND appropriateness method. Eventually, based on the literature review and our own results of the interview analysis, a manual consisting of five main sections and one clause on ethics was developed. Later, a pilot study was conducted on ten family physician topics, and prioritized by nine experts.Conclusions:The manual can be eyed as a tool ensuring the quality of the process of prioritizing CPG topics for family physicians, as it takes into account the issues involved in priority-setting. Selecting informed stakeholders for rating the criteria and ranking the topics was an issue that was greatly emphasized by the experts. Eventually, the application of this manual can be the first step toward systematizing the process of prioritizing CPG topics in the country.

Obese children with AN are at risk of developing diabetes. Hence early identification of this feature and precise evaluation of children is recommended.

Introduction: The strict control of blood glucose levels in adolescents with Type 1 Diabetes Mellitus (T1DM) is accompanied with a considerable long term decrease in microvasular and macrovascular complications.Aim: This study was conducted to investigate the effect of metformin as an adjunct therapy in adolescents with poorly controlled Type 1 diabetes.